The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Letter to the Editor

Cholangiocarcinoma and Paraneoplastic Hypercalcemia: A Lethal Combination Revisited

Authors: Guru Trikudanathan, MD, Constantin A. Dasanu, MD, PhD

Abstract

To the Editor:


Over the last decades, few reports have linked cholangiocarcinoma with humoral hypercalcemia of malignancy (HHM). We present herein a female patient with cholangiocarcinoma involving multifocally the right hepatic lobe. In our patient, the HHM was the presenting clinical sign, leading to increasing confusion and somnolence. Most of the previously reported cases of cholangiocarcinoma-HHM had been from Japan. The cholangiocarcinoma showed a male predominance and predilection for the right hepatic lobe involvement. In most cases, hypercalcemia occurred from weeks or months prior to the patient's demise. HHM may represent a marker of poor prognosis in cholangiocarcinoma.

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